The document discusses issues related to the UK's medical workforce. It notes that the population is aging rapidly, with more people over 65 and 85 years old. This will increase demand for healthcare services. Currently, the UK has fewer doctors per capita than most other developed countries. Several medical specialties already have vacancies for trainees and consultants. To meet quality standards, several pediatric subspecialties will need significant increases in consultants. The aging population and moves to a 7 day consultant-led NHS will further increase demand for doctors going forward.

1. MEDICAL WORKFORCE ISSUES
IN THE UK
Professor Terence Stephenson
Chairman, Academy of Medical Royal Colleges
Nuffield Professor, Institute of Child Health,
University College London

2. The Academy of Medical Royal Colleges
• Represents almost all the 220,000 licensed doctors in the UK
• Acts for patients by setting professional standards of care and
determining postgraduate training of tomorrow’s doctors
• NOT a trade union (British Medical Association)
• NOT a regulatory or licencing organisation (General Medical Council)
• NOT a medical protection organisation (MDU, MPS)
• INDEPENDENT of government and industry – a charitable organisation
funded by members’ subscriptions

3. UK Medical Workforce
Consultants 35,950
Trainees 51,502
Staff and Associate Specialists 10,178
Other 2,998
GPs 40,269
Total doctors 140,897
Qualified nursing staff 417,164
Total staff 1,431,996

4. The CENTRE FOR WORKFORCE INTELLIGENCE
It was never going to be easy

5. The number of
people over 65
years will
increase by 65
per cent in the
next 25 years
to more than
16.4 million in
2033
The number of
over 85s in the
UK is set to
double in the
next 20 years
and nearly
treble in the
next 30.

6.  People aged over 60 make up
nearly a quarter of Britain’s
population
 Half of those currently aged over
60 have a chronic illness
 Nearly two-thirds of patients
admitted to hospital are over 65
years old
 On average, each patient has 3
different conditions

9. Paediatrics – 2004 survey
• Trainees: 70% women; 20% P/T
• 1997: 90,000 NHS Drs
• 2008: 133,000 NHS Drs
• 50% train < F/T; 21% work P/T most of career; 80%
want to take a career break
• Need to increase from 1733 wte to 2331 Acute Paeds
Cons; 637 to 915 Comm Paeds; 731 to 1123
Specialist Cons
Table 1 shows the numbers and percentages of the respon
flexible/part time. 32% of the trainees were working flexible/part
on average 0.61 of a whole time equivalent.
Table 1: Flexible/Part Time Trainees
Total Male Female
Flexible/Part Time 51 5 46
32% 7% 49%
Full Time 109 62 47
68% 93% 51%
160 67 93
Flexible/part time training is more common for women with 49%
flexibly or part time compared to only 7% of the male responden

10. 1. ED Attendances increased by 1 million in last 3 years and
250,000 in last 12 months
2. Average number of consultants = 7. Need minimum of 10 to
provide sustainable cover 16hrs per day 7 days per week
3. 196 ED departments therefore almost 600 consultants short
4. Trainee recruitment into ST4 posts has been @ 50% for last 3
years.
5. Last year over 50 consultants emigrated (5% of the workforce)
in previous years it was about 1%

11. Paediatrics – 2004 survey
• Trainees: 70% women; 20% P/T
• 1997: 90,000 NHS Drs
• 2008: 133,000 NHS Drs
• 50% train < F/T; 21% work P/T most of career; 80%
want to take a career break
• Need to increase from 1733 wte to 2331 Acute Paeds
Cons; 637 to 915 Comm Paeds; 731 to 1123
Specialist Cons
Table 7 shows, excluding the one post for which neither full time or part time was spe
number and percentages of trainees who intend to work full and part time post CCST.
Table 7: Part Time Working Post CCST
All Posts UK Paediatric Consultant Post
Total Male Female Total Male Female
Full Time 94 65 29 85 60 25
59% 98.5% 31.2% 59% 98.4% 30.5%
Part Time 65 1 64 58 1 57
41% 1.5% 68.8% 41% 1.6% 69.5%
159 143
59% of the trainees intend to work full time once they have gained their CCST, this perc
mirrored in the subgroup of trainees who intend seeking a full time UK paediatric consu
The average preferred number of programmed activities (PA) for those who wish to work
is 6.5; the responses ranged from 4 to 9 PAs. Females account for the majority (98%) o
who wish to work part time once they have gained their CCST.
Notably in comparison with the information from the College 2003 workforce census
Table 7: Part Time Working Post CCST
All Posts UK Paediatric Consultant Post
Total Male Female Total Male Female
Full Time 94 65 29 85 60 25
59% 98.5% 31.2% 59% 98.4% 30.5%
Part Time 65 1 64 58 1 57
41% 1.5% 68.8% 41% 1.6% 69.5%
159 143
59% of the trainees intend to work full time once they have gained their CCST, this percentage is
mirrored in the subgroup of trainees who intend seeking a full time UK paediatric consultant post.
The average preferred number of programmed activities (PA) for those who wish to work part-time
is 6.5; the responses ranged from 4 to 9 PAs. Females account for the majority (98%) of trainees
who wish to work part time once they have gained their CCST.
Notably in comparison with the information from the College 2003 workforce census 80.3% of
existing consultants work full time compared with only 59% of the survey respondents intending to
work full time post CCST.
2.3 Type of Post

13. % of children with diabetes admitted with
ketoacdosis over last 5 yrs – 7 fold
variation

14. Service change

15. 7 day service – 3 meanings

16. Paediatrics
• 1997: 90,000 NHS Drs
• 2008: 133,000 NHS Drs
To meet RCPCH standards of care:
• Need to increase from 1733 wte to 2331
Acute Paediatric Consultants;
• 637 to 915 Community Paediatric
Consultants;
• 731 to 1123 Specialist Paediatric
Consultants

17. 1. There is no voluntary medical unemployment in England
2. There are specialties with vacancies for trainees and
consultants
3. Taking 1 and 2 together, there is currently no surfeit of
doctors
4. The NHS aspires to be the best in the world but has fewer
doctors per 1000 population than most OECD countries
5. The demand for doctors will increase with an ageing
population and a 7 day consultant present service
6. Producing more CCT holders than retiring consultants is NOT
= Producing too many doctors

18. Thank you
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www.aomrc.org.uk
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